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目的:探讨糖尿病性神经病的电生理改变特征。方法:在80例Ⅱ型糖尿病患者中,有神经病学症状或体征的39例为A组,无神经病学症状或体征的41例为B组。C组为正常对照。在三组中测定胫神经运动神经传导速度(MCV),远端潜伏期(DPL),复合肌肉动作电位(CMAP)的波幅、时限,检测数据进行t检验。结果:A组与B、C组分别对比,A组MCV减慢(69%),DPL延长(53.8%),cMAP波幅降低(35.9%),时限延长(51.2%),有显著差异(P<0.01)。B组与C组对比,B组CMAP波幅降低,有显著差异(P<0.05),B组17%DPL延长,7.3%CMAP时限延长。各组内远端与近端刺激引出的CMAP波幅、时限对比均无显著差异(P>0.05)。A组电生理异常率为100%,B组为26.8%。A组病程长但血糖水平同B组相近。结论:了解胫神经的电生理改变有助于评价糖尿病性远端神经病与临床病程、进展的关系。
Objective: To investigate the electrophysiological characteristics of diabetic neuropathy. Methods: Of 80 patients with type 2 diabetes mellitus, 39 patients with neurological symptoms or signs were in group A and 41 patients without neurological symptoms or signs were in group B. Group C as a normal control. The tibial nerve motor nerve conduction velocity (MCV), distal latencies (DPL), amplitude and duration of the compound muscle action potential (CMAP) and t test were measured in the three groups. Results: Compared with group B and group C, group A showed a significant difference in MCV (69%), DPL prolongation (53.8%), cMAP amplitude decrease (35.9%) and time extension (51.2% 0.01). Compared with group C, the amplitude of CMAP in group B decreased significantly (P <0.05), while in group B, 17% of DPL and 7.3% of CMAP were prolonged. There was no significant difference in amplitude and duration of CMAP induced by distal and proximal stimulation in each group (P> 0.05). The electrophysiological abnormalities in group A were 100% and in group B 26.8%. A group of longer duration but similar to the B group of blood glucose levels. Conclusion: Understanding the electrophysiological changes of tibial nerve helps to evaluate the relationship between diabetic distal neuropathy and clinical course and progression.